Technical Field
[0001] The present invention is related to an ambulatory medical device. The ambulatory
medical device may especially be a pocket-sized device and may be carried by the user
frequently or continuously. Such devices are, for example, insulin pumps for Continuous
Subcutaneous Insulin Infusion (CSII) and continuous as well as noncontinuous glucose
measuring devices as typically used in the framework of diabetes therapy.
Background Art
[0002] Typical extracorporeal insulin pumps are carried by a patient night and day and are
disclosed, e.g., in
US 6878132 and are manufactured, among others, by Disetronic Medical Systems AG, Switzerland.
In the following, reference is mainly made to extracorporeal insulin pumps for illustrative
purposes without excluding other ambulatory devices.
[0003] Insulin pumps typically require a number of service operations to be performed by
the user, in particular service operations for replacing disposables. While some of
those disposables have a specified lifetime, the lifetime of other disposables is
highly dependent on the individual application conditions and may vary in a large
range. For example, a typical drug cartridge stores a maximum of 3ml or 300 IU (International
units) of insulin and may have an average lifetime of one week or even more than one
week for a first patient and of 3 days for a second patient. Furthermore, the lifetime
of many disposables is not constant but shows a significant variability even for one
and the same patient or user. Alerts are provided by insulin pumps to inform the user
about upcoming service operations and typically comprise an acoustic and/or tactile
indication. Such alerts, however, are often felt as bothersome and inconvenient.
[0004] In order to reduce inconvenience resulting from the need for replacing disposable
and carrying out further service operations, insulin pumps are available, such as
the OmniPod® system from Insulet Corporation, USA, which reduce the operation to replacing
the infusion pump as a whole every few days. However, those disposable pumps are critical
with respect to long-term costs, as well as waste generation and wearing comfort for
some users.
[0005] The Patent Application Publication
US 2008/033357 A1 discloses an external infusion device that is designed to provide "Low Reservoir
Alert". The alert will sound when the plunger of the external infusion device reaches
the point where approximately e.g. 0. 200 ml of fluid remains in the reservoir. If
correction of the low volume has not happened at an approximate level of 0.100 ml,
the external infusion device 10 will beep again. The device is further designed to
provide a low battery alarm.
Summary of the Invention
[0006] It is the overall objective of the present invention to provide ambulatory medical
devices of improved user acceptance and convenience.
[0007] The present invention results from the insight that many alerts, in order to fulfill
their intended purpose, do not necessarily have to be generated at a specific point
in time but may be generated within a time interval of typically several hours. In
some cases, the interval may be as long as 12 hours or even longer. According to the
present invention, the time interval defines a degree of freedom for alert generation
such that an alert may be generated at an especially suited point in time of the corresponding
interval based on one or multiple alerting criteria.
[0008] In contrast to the present inventions, state-of-the-art devices do not consider such
intervals but generate an alert at exactly the point in time a pre-specified alerting
condition is met, such as a battery voltage falling below a threshold battery voltage
or the drug volume stored by a drug reservoir falling below a specified threshold
volume.
[0009] An ambulatory medical device according to the present invention comprises:
- a) a device controller, the device controller being configured to control the operation
of the ambulatory medical device,
- b) an alert controller, the alert controller being configured
- to determine a first alerting interval, the first alerting interval defining an earliest
point in time and a latest point in time for an alert generation due to a first alerting
cause,
- to determine in the first alerting interval an alerting point in time based on an
alerting criterion,
- to generate an alert trigger at the alerting point in time,
- c) an indicator, the indicator being configured to generate an alert upon generation
of the alert trigger.
[0010] In typical embodiments, the alert controller is realized by electronic circuits and
may especially be integral with the device controller. The device controller typically
comprises components well known in the art for such units, like microcontrollers,
memory components, clock circuits, power management circuits, and the like.
[0011] In some embodiments, the ambulatory medical device is adapted to transmit alert triggers
to an external device such as a cell phone or a remote controller of the ambulatory
medical device. In this way, an alert may be generated on the external device. For
this purpose, the ambulatory medical device may comprise interface units such as a
wireless RF interface unit and/or an Infra Red IR interface unit.
[0012] In some embodiments, the ambulatory medical device is made of at least two physically
separate units, such as an administration unit and a separate controller and operation
unit. These units are adapted to exchange information and the alert controller as
well as the at least one indicator may be comprised by either or multiple of the units.
[0013] In some embodiments, indicator is designed to provide at least one of an optical,
a tactile or an acoustic indication. Optical indication is preferably provided by
a display but may also be provided by other optical indicators such as LED's. Audible
indication and/or tactile indication may be provided, for example by a buzzer and/or
a pager vibrator, respectively. In particular embodiments, the indicator comprises
an optical indicator and at least one of an audio indicator or a tactile indicator.
For this type of embodiment, the alert comprises an audible alert and/or a tactile
alert in order to draw the user's attention onto the occurrence of the alert. Further
information with respect to the alerting condition, such as an identification of the
alerting cause, is advantageously provided by an optical indicator, in particular
by a display.
[0014] The point in time where the alerting criterion is met defines the point in time where
an alert trigger is generated within the running first alerting interval. An alerting
interval is referred to as 'running' in the time interval which is limited by the
earliest and the latest point in time for an alert generation. As will be discussed
below in more detail, the alerting criterion may, for example, be met if a further
alerting interval for a further alerting cause is ending while the first alerting
interval is running. By this means, the overall number of different points in time
at which alerts are generated can be reduced, thus increasing the user convenience.
In another example, the alerting criterion is met at a point in time within a running
alerting interval that is especially suited for an alert generation from the user's
point of view.
[0015] Generally spoken, the combination of alerting interval and alerting criterion allows
to take advantage of the fact that alerts have t be generated within a certain timeframe
which is given by the alerting interval, but allow some flexibility with respect to
the exact point in time.
[0016] The earliest and the latest point in time for an alert generation define the time
interval in which an alert due to the first alerting cause should be generated. Within
this interval, the exact point in time is defined according to the alerting criterion.
In this context, the term 'within' also includes the end points of the time interval,
i.e., the earliest and the latest point in time for the alert generation. The determination
of alerting intervals will become more readily apparent as the description proceeds.
[0017] The first alerting cause is approaching exploitation of a disposable and the first
alerting interval reflects an earliest and a latest grade of exploitation for replacing
the first disposable. An alert which is triggered by the approaching exploitation
of a disposable may be referred to as 'Exploitation Alert' and a corresponding alerting
interval as 'Exploitation alerting interval' for clarity reasons.
[0018] The term 'Disposable' refers to elements which are required for operating the portable
medical device according to its intended use and only have a limited lifetime after
which they have to be replaced, exchanged or refurbished. The term 'Replacing' is
used in the following for all of those actions. In most cases, the disposables are
discarded after use.
[0019] The terms 'Exploitation' and 'Grade of Exploitation' refer to reducing the remaining
useful lifetime of a disposable due to its usage. At the end of its lifetime, a resource
is considered as being exploited. For example, a drug-filled reservoir is exploited
if it is substantially empty and a battery is exploited if it does not store sufficient
remaining energy for securely powering the device.
[0020] The earliest point in time for generating an alert is typically given when the grade
of exploitation is still low but sufficiently high to justify replacement without
substantial waist of remaining lifetime of the disposable. The latest point in time
for generating the alert is typically given when the disposable is substantially exploited,
thus requiring immediate or soon replacement. The latest point in time, however, may
also be chosen somewhat before this condition is met since it may not be possible
and/or convenient for the user to replace the disposable immediately when the alert
is generated.
[0021] In some embodiments, the first disposable is either of an energy storage, such as
a battery, a drug reservoir, an infusion line, an infusion cannula, a valve, a sealing,
or a glucose measurement probe
[0022] Sealings, such as O-ring sealings, are used in some ambulatory medical devices to
prevent fluids, especially water, as well as dust from entering the device. Valves
are used, among others, to improve the safety of insulin pumps and have to be regularly
replaced in order to prevent hazards such as contamination or clogging of fluid channels.
[0023] For some disposables, the lifetime is substantially constant. This is typical, for
example, for infusion lines and cannulas as used in CSII, or for electrochemical glucose
measurement probes as used for continuous glucose monitoring. For those disposes,
the grade of exploitation may be monitored by timers which are reset when the disposable
is replaced. The earliest and the latest point in time for the alert generation may
be determined by comparing the past usage time or the maximum remaining usage time
till exploitation with an early alerting threshold time and a late alerting threshold
time. In combination, the two threshold times define the corresponding alerting interval.
[0024] Because the lifetime of many disposables is to some degree dependent on factors such
as the average ambient temperature and personal factors such as skin irritation resulting
from plaster adhesives, the thresholds are advantageously parameters which may be
set and/or modified by the user and/or a healthcare professional.
[0025] For other disposables, such as batteries or drug cartridges, the lifetime is largely
dependent on the user's individual therapy, lifestyle and habits. The insulin consumption
of a diabetic person, for example, varies in a large range between persons and also
from day to day, the insulin consumption affecting both the lifetime of the insulin
reservoir and the energy source, especially a battery. The lifetime of typical energy
sources is further dependent on factors as the usage of a typically provided display
backlight and the amount of wireless RF communication with external devices.
[0026] For monitoring the grade of disposable exploitation, the alert controller advantageously
comprises a disposable monitoring unit which is configured to measure or compute the
grade of exploitation in continuous or cyclic way. The alert controller advantageously
further comprises an exploitation computation unit which is operatively coupled to
the disposable monitoring unit and determines the alerting interval, for example by
comparing the grade of exploitation with an early alerting threshold and a late alerting
threshold, respectively. The operation of disposable monitoring units and exploitation
computation units will become more readily apparent as the description proceeds.
[0027] The alert controller is configured
- to determine a further alerting interval, the further alerting interval defining an
earliest point in time and a latest point in time for an alert generation due to a
further alerting cause, and
- to detect an overlap interval of the first alerting interval and the further alerting
interval,
wherein the alerting criterion is provided such that the alert is generated in the
overlap interval and the alert is a common alert for the first alerting cause and
the further alerting cause and the indicator is configured to indicate the first alerting
cause and the further alerting cause.
[0028] As will be seen below, the invention may be extended to any number of alerting causes.
This kind of embodiment allows reducing the overall number of alerts that are generated
at different point in time.
[0029] The information with respect to the alerting causes is preferably provided by an
alphanumeric or numeric information on a display, but may also be provided by other
optical indicators, such as a set of LEDs, by activating an acoustical and/or a tactile
indicator according to an interval identifying the alerting causes, or the like.
[0030] The further alerting cause is approaching exploitation of a further disposable and
the further alerting interval reflecting an earliest alerting grade of exploitation
and a latest alerting grade of exploitation of the further disposable.
[0031] In some embodiments the alerting criterion is provided such that the alert triggers
is generated at the end of either of the first alerting interval or the further alerting
interval, respectively.
[0032] The rationale for this type of embodiment is based on the following considerations:
- I. As long as the grade of exploitation of either of the disposables is too low to
justify its replacement, an alert should not be generated for the replacement of that
disposable, indicated by a corresponding exploitation alerting interval having not
jet started.
- II. An exploitation alert should be generated for the replacement of that disposable
if it is almost fully exploited, indicated by the ending of the corresponding exploitation
alerting interval. Here, an alert is generated independent of the other disposable.
- III. In the alerting interval between the earliest and the latest grade of exploitation,
an exploitation alert with respect to either of the disposables does not yet need
to be generated. But it may be generated without a replacement of the disposable resulting
in an exhaustive waist of lifetime of the disposable. An alert may especially be generated
if an exploitation alert for another disposable has to be generated anyway. In this
case, the alert is a common alert.
[0033] It will be appreciated by a person skilled in the art that the role of the first
alerting cause and the further alerting cause are equitable and interchangeable. In
addition, the approach can applied to any number of alerting causes in a straight-forward
way. Therefore, the term 'alerting cause' refers to any alerting cause in the following.
Alert generation is generally not equally convenient and acceptable for the user for
all points in time. In particular, the generation of an alert is typically judged
as inconvenient and disturbing during night time. In some embodiments, embodiments,
the alerting criterion therefore comprises a time-dependent user acceptance for the
generation of alerts. In the following, the user acceptance for alert generation is
referred to as 'user acceptance' where no ambiguity may arise.
[0034] In some embodiments which involve the consideration of user acceptance, it is considered
in a binary way. Here, high user acceptance indicates that alert generation is accepted
while low user acceptance indicates that alert generation is undesired and/or not
accepted at a given point in time.
[0035] In some embodiments considering user acceptance, the alert controller is configured
to detect an overlap interval of high user acceptance and a further alerting interval.
[0036] The alert controller is configured to generate an alert trigger in the overlap interval.
[0037] In embodiments considering both the user acceptance and the acceptance of a disposable
replacement with respect to exploitation in a binary way, the alert controller may
especially be configured to generate an alert trigger when an overlap interval of
an alerting interval and an interval of high user acceptance ends. This is the case
when the user acceptance changes from 'high' to 'low', assuming that alt least one
alerting interval is running at that point in time. In this way, an alert which would
generally occur at a point in time where user acceptance is low can be presumed to
that point in time where user acceptance changes from 'high' to low'. This is the
latest point in time where alert generation is accepted by the user and the disposable
has already been exploited to a grade which justifies its replacement. However, an
alert should further be generated when an alerting interval ends independent of the
user acceptance.
[0038] Some embodiments which consider user acceptance, the device comprises a user acceptance
storage which is configured to store a user acceptance profile. The user acceptance
profile is indicative for the user acceptance as a function of time. Therefore, the
day may, e.g., be divided into a number of equal intervals and a corresponding value
for the user acceptance may be stored by the user acceptance profile storage for each
of the intervals.
[0039] The times of day which are convenient and accepted by the user for alert generation
may be different for working days and for weekends. Similarly, they may be different
for different days, e.g., if the user is a shift worker. Therefore, the user acceptance
storage preferably comprises a set of storages for a set of user acceptance profiles,
each user acceptance profile defining the user acceptance in dependence on the time
of day. The administration device may be adapted for manually changing between the
user acceptance profiles based on user input and/or automatically changing between
the user profiles based on changing rules.
[0040] In some embodiments, the device controller is configured to store a history and the
alert controller is configured to modify the user acceptance profile based on data
stored in the history.
[0041] The history typically stores information with respect to a variety of events, such
as the on-demand administration of drug boli, the occurrence of error states, the
replacement of a drug reservoir, device reprogramming, and the like. The occurrence
of an event is stored along with a time stamp. This information may advantageously
be used to modify the user acceptance profile. Because many of the events involve
a user operation, such as the on-demand administration of drug boli, the user acceptance
may be assumed to be low at times of rare user operations.
[0042] A history may be statistically evaluated by a history evaluation unit to determine
time patterns, such as times of day, which indicate frequent and/or regular user operations.
For this purpose, the 24 hours of the day may be segmented into a number of intervals,
each having a duration of, e.g., 30 min, and the past average number of user operations
may be determined for each interval. Intervals of high user acceptance may be determined,
for example, by defining at least one threshold user operations number and assuming
high user acceptance at intervals showing an average user operations number exceeding
the threshold user operations number and/or by determining intervals of maximum user
operations. Adoption of the user acceptance profile may be performed continuously
and/or only during a learning period of, e.g., some weeks.
[0043] In some embodiments, the alert controller is configured to temporarily modify the
user acceptance in accordance with data provided via a user interface and/or a data
interface of the ambulatory medical device.
[0044] In some embodiments, a user interface and/or a data interface of the device is configured
to receive data defining a modification time interval, and the alert controller is
configured to temporarily modify the user acceptance for that modification time interval.
[0045] Such temporary modification of the user acceptance may be performed by the user,
for example, by first entering a modification duration or a modification end time
and second setting the user acceptance to 'low' for the modification duration or until
the entered modification end time, respectively. A temporary modification of user
acceptance is advantageous in spontaneously occurring situations of low user acceptance
for the alert generation, for example when attending a meeting, being in a concert,
or the like.
[0046] In some embodiments involving user acceptance, the user acceptance is modified on
at least one of the occurrence a user interaction with the ambulatory medical device,
the occurrence of an error state, and the resolving of an error state.
[0047] Any kind of user interaction with the ambulatory medical device indicates that the
user is in interaction with the device and may accordingly accept alerts even if the
general user acceptance is currently low. This is the case, for example, if the user
commands the administration of an insulin bolus during nighttime because on an evening
which differs from the user's usual habits. In especially preferred embodiments, the
user acceptance may be modified only for a defined subset of user operations. If the
user, for example, administers an insulin bolus during nighttime, he has typically
not yet gone to bed and may accordingly accept alerts. The backlight, on the contrary,
may be switched on by the user just for reading the device clock while the user is
in bed. Here, the user may not be willing to accept the generation of an alert which
could also be generated the following morning.
[0048] In some embodiments, the alert controller comprises a prediction unit which is configured
to predict at least one of an alerting interval or an alerting point in time. The
term 'Predicting an interval' means predicting the point in time the interval starts
and/or the point in time the interval ends. For predicting alerting intervals with
respect to the exploitation of disposables, the prediction unit is preferably adapted
to predict the grade of exploitation of the disposables as a function of time.
[0049] By predicting alerting intervals, the alerting times may be further optimized. Predicting
alerting intervals is especially favorable in embodiments which consider user acceptance,
wherein the user acceptance is preferably predicted, too. If the prediction indicates
the generation of an alert at a future point in time of predicted low user acceptance,
e.g., during the night, the alert generation may be presumed to an earlier point in
time or delayed to a later point in time where the user acceptance is high. It should
be noted that predicting user acceptance as stored by a preferably present user acceptance
profile is exact and straight-forward, as long as the user acceptance is not modified.
[0050] The exploitation of many disposables is typically not independent from the time of
day. Therefore, a prediction unit may be adapted for prediction in dependence of the
time of day. For example, a basal insulin administration profile is variable over
the time of day and insulin boli are administered by an insulin pump in CSII therapy
mainly at meal times. The administration affects both the remaining drug volume which
is stored by a drug reservoir and the energy stored by an energy storage. Similarly,
other operations requiring considerable amounts of energy, such as activating a preferably
display backlight or performing wireless communication with remote devices is likely
to be, at least in part, dependent on the time of day. The time of day may be considered
based on a pre-defined exploitation model in dependence of the time of day, the exploitation
model being factory set and/or provided by the user and/or a healthcare professional.
[0051] In some embodiments involving a predication unit, an additional history evaluation
unit is present. The history evaluation unit is configured to evaluate data stored
in a history of the device controller with respect to past disposable exploitation.
Here, the prediction unit is configured for adaptive prediction in accordance with
the history evaluation.
[0052] Prediction may be performed, e.g., based on the average exploitation of a disposable
in dependence of the time of day, such as past drug administration and/or past energy
consumption. In addition or alternatively to the average exploitation, other criteria
such as past exploitation maxima or a given quantile, e.g. the 75% quantile of past
exploitation of a disposable within a given interval may be considered.
[0053] Alternatively to adaptive prediction, the history evaluation unit may be configured
to evaluate the data stored in the history for a learning period of, e.g., some weeks
in order to adjust an exploitation model.
[0054] In some embodiments, the device controller is adapted to control the at least one
indicator of the device to generate reminder alerts which may be used to remind the
user, e.g., to take in food some time after administering an insulin bolus or to measure
his blood glucose value some time after food intake. For such embodiments, an alerting
interval may be a reminder alerting interval which is determined by a corresponding
reminder alerting cause. Reminder alerting intervals may preferably be associated
with corresponding reminder alerting signals which may be generated by a clock circuit
of the ambulatory medical device and may be defined in an analogue way as described
above for resource alerting signals. Reminder alerts may, mutas mutandis, be considered
in an analogue way as alerts which are associated with disposable exploitation.
[0055] Further favorable embodiments of ambulatory medical devices in accordance with the
present invention may be derived from the exemplary embodiments as described in the
following with reference to the figures.
Brief Description of the Figures
[0056]
Figure 1 shows the internal structure of an insulin pump as an exemplary ambulatory
medical device according to the present invention.
Figure 2 shows a more detailed structural view of an exemplary alert trigger unit
in connection with supplementary exemplary components for a device according to Figure
1.
Figure 3 shows an exemplary course of different signals for an arrangement according
to Figure 2.
Figure 4 shows a more detailed structural view of another exemplary alert trigger
unit in connection with supplementary exemplary components for a device according
to Figure 1.
Figure 5 shows the major steps performed by an alert trigger unit and supplementary
components for an arrangement according to Figure 4.
Figure 6a and Figure 6b show an exemplary course of different signals for an arrangement
according to Figure 4 and Figure 5.
Exemplary Embodiments
[0057] Figure 1 schematically shows the internal structure of a miniaturized administration
device, especially of an insulin pump as typically used for diabetes therapy by CSII
in accordance with the present invention.
[0058] The administration device comprises a drug reservoir 20, an infusion line 25, and
an infusion cannula 27 which is placed in the subcutaneous tissue. The drug reservoir
20 may, for example, be a cylindrical cartridge storing a maximum of 3.15ml of insulin,
with each ml of insulin corresponding to 100 International Units (IU). The drug reservoir
20 is expelled via a pump unit 60 which may be designed, for example, according to
the disclosure of
EP1124600B1 or
EP0991440B1.
[0059] The exemplary administration devices further comprises a user interface 50 with a
keyboard 40, a display 30, an acoustic indicator 33, such as a buzzer and a tactile
indicator 35, such as a pager vibrator.
[0060] The operation of the administration device is controlled by the device controller
80. The device controller 80 is realized as an electronics circuit with one or multiple
micro controllers, static and dynamic memory, a clock circuit, a power circuit for
controlling the pump unit 60, safety circuits, and the like.
[0061] The device controller 80 is connected to a rechargeable or non-rechargeable battery
85 as energy supply.
[0062] The administration device further comprises two bidirectional data interfaces, namely
an Infra Red IR data interface 90 and a Radio Frequency RF data interface 95, for
configuration, remote control and data exchange purposes.
[0063] The exemplary administration device further comprises an alert controller 100, 100'
which is operatively coupled to the controller device 80. The functional components
of the alert controller 100, 100' may be realized integral with the device controller
80. The alert controller 100, 100' comprises an alert trigger unit 130, 130' (shown
in Figure 2 and Figure 4) as well as supplementary components used in combination
with the alert trigger unit 130, 130'.
[0064] It should be noted that the exemplary embodiments only consider two disposables,
namely a drug reservoir and a battery. These disposables are of particular importance
in the framework of diabetes therapy. However, the exemplary embodiments may be extended
and modified to consider any number of disposables in dependence of the specific ambulatory
medical device. Insulin pumps for example, may comprise lifetime timers for disposables
such as cannulas, infusion lines, valves and sealings having a fixed lifetime as described
above in the general description of the invention. The exemplary embodiments may further
be extended to consider reminder alerts as described above.
[0065] Figure 2 shows a more detailed structural view of the exemplary alert controller
100 along with the device controller 80 and the battery 85 as shown in Figure 1. The
alert controller 100 comprises a disposable monitoring unit 110, an exploitation computation
unit 120, and an alert trigger unit 130. The disposable monitoring unit 110 comprises
a reservoir monitoring unit 112 and a battery monitoring unit 114. The exploitation
computation unit 120 comprises a reservoir exploitation unit 122 and a battery exploitation
unit 124.
[0066] The reservoir monitoring unit 112 is adapted to compute the volume of insulin stored
by the drug reservoir 20 as a function of time. For computing the volume, the reservoir
monitoring unit 112 is operatively coupled to the controller 80 to receive information
about the initial insulin volume which is stored in a fresh reservoir and to further
receive information with respect to the insulin volume administered from the reservoir.
In a slightly modified embodiment, the reservoir supervising 112 unit is operatively
coupled to or comprises a reservoir volume measurement unit, the reservoir volume
measurement unit being adapted to measure the volume as a function of time.
[0067] The reservoir monitoring unit 112 is operatively coupled to a reservoir exploitation
unit 122, the reservoir exploitation unit 122 and being adapted to compute a binary
reservoir alerting signal. The reservoir alerting signal is computed by comparing
the drug volume V in the reservoir with an early reservoir threshold volume and a
late reservoir threshold volume. For a standard insulin cartridge having an initial
volume of V
0 = 315 IU, an early reservoir threshold volume may be, e.g., 40 IU and a late reservoir
threshold volume may be, e.g., 15 IU. The early reservoir threshold volume and the
late reservoir threshold volume may be set or modified by the user and/or a healthcare
professional via the user interface 50 and/or the data interfaces 90, 95. In combination,
the early reservoir threshold volume and the late reservoir threshold volume define
a reservoir alerting interval.
[0068] The early reservoir threshold volume may especially be set in dependence of the user's
basal insulin demand and may be, for example, the 1.5-fold or 2-fold of the basal
insulin demand. This is based on the fact that, for many diabetics, the basal insulin
demand is approximately half of the total daily insulin demand. Setting the early
reservoir threshold volume, for example, to the two-fold of the known basal demand,
results in the corresponding alerting interval beginning about one day before the
cartridge is actually exploited.
[0069] The battery monitoring unit 114 is adapted to compute or determine a measure of the
amount of energy which is stored by the battery 85 as a function of time. This may
by done by various methods which are known in the art, such as integrating the battery
current over time and/or measuring the battery voltage as a function of time. Further
factors such as the ambient temperature and/or the number of charging cycles in case
of the battery 85 being rechargeable. Advanced methods for determining the remaining
capacity of a battery which are particularly suited are known in the art as 'fuel
gauging' and may be used as well. In embodiments where the battery is a standard battery,
the battery monitoring unit 114 is preferably integral with the device controller
80. In embodiments where the battery 85 is a rechargeable battery, the battery monitoring
unit 114 may, totally or in part, be comprised by the battery 85, such that the battery
and the battery monitoring unit, in combination, form an 'intelligent' power pack.
[0070] The battery monitoring unit 114 is operatively coupled to a battery exploitation
unit 124, the battery exploitation unit 124 being comprised by the exploitation computation
120 and being adapted to compute a binary battery alerting signal based on a measure
of the remaining energy which is stored by the battery 85. The computation may be
done in an analogue way to the reservoir alerting signal.
[0071] The battery alerting thresholds may be, e.g., set such that the early battery alerting
threshold is passed at about 40% of the initial energy and the late battery alerting
threshold is passed at about 20% of the initial energy which is stored by a fresh
and/or fully charged battery.
[0072] When computing the battery alerting signal, the energy which is stored by the battery
is preferably assumed to have fallen below an alerting threshold if it has fallen
below the corresponding threshold for the first time. Due to computational errors,
battery recovery, temperature changes, and the like, the measured or computed energy
stored by the battery may rise above the corresponding threshold which should not
be considered.
[0073] The battery alerting signal and the reservoir alerting signal reflect the beginning
and the end of the battery alerting interval and the reservoir alerting interval,
respectively. In the following, they are assumed to be defined such that the value
of the corresponding signal is Boolean '1' in the corresponding exploitation alerting
interval and is Boolean '0' otherwise. Other representations, however, may be equally
used. Using this signal definition, the alert trigger unit 130 is adapted to generate
an alert trigger upon the falling edge of either of the battery alerting signal or
the reservoir alerting signal. A binary alert trigger signal is determined by the
alert trigger unit 130, such that the value of the alert trigger signal is generally
constant, e.g., '0' and defines the alert trigger as a pulse of the opposite Boolean
value, e.g., '1'. The alert trigger signal is fed into the controller 80 of the administration
device along with further information, in particular information being indicative
for the alerting cause or alerting causes, i.e., the disposable or disposables for
which exploitation is approaching.
[0074] Upon generation of an alert trigger, the controller 80 controls the indicator 30,
33, 35 to generate an alert which is indicative for the approaching exploitation.
The alert comprises an acoustic indication via the acoustic indicator 33 and/or the
tactile indicator 35. The alert further comprises a visual indication via the display
30.
[0075] The alert trigger unit 130 is adapted to perform its operation above repeatedly and
substantially continuously with a computation interval of, e.g., 1 sec or a fraction
of a second. For this purpose, the alert trigger unit 130 as well as the supplementary
components of the alert controller 100 is adapted to receive computation triggering
pulses from the device controller 80. The alert controller 100 is further adapted
to operate on the occurrence of triggering events such as a user interaction with
the administration device and/or the occurrence of an error state of the administration
device.
[0076] Figure 3 shows an exemplary course of the battery alerting signal 205, an exemplary
course of the reservoir alerting signal, 210, and an the course of the alert trigger
signal, 220.
[0077] At a first point in time, ti, the energy which is stored by the battery 85 falls
below the early battery alerting threshold energy. Consequently, the battery alerting
signal changes from '0' to '1', as indicated by the rising edge 207. At a second point
in time, t
2, the drug volume which is stored by the drug reservoir 20 falls below the early reservoir
threshold volume. Consequently, the reservoir alerting signal changes from '0' to
'1', as indicated by the rising edge 212. At a third point in time, t
3, the drug volume falls below the late reservoir threshold volume. Consequently, the
reservoir alerting signal changes from '1' to '0', as indicated by the falling edge
214. The rising edge 212 and the falling edge 214 of the reservoir alerting signal
210 define a reservoir alerting interval 217, which, in this specific example, also
is an overlap interval 218. The falling edge 214 of the reservoir alerting signal
210 triggers the generation of a positive pulse 222 of the alert trigger signal 220.
The pulse 222 serves as alert trigger. Accordingly, the third point in time t
3 is an alerting point in time and the device controller 80 triggers the generation
of an alert by the indicators 30, 33, 35. The alert indicates that the reservoir 20
should be replaced soon and the battery 85 may be replaced along with the reservoir
20 with an acceptable grade of exploitation.
[0078] Figure 4 shows a structural view of a further exemplary alert controller 100' along
with the device controller 80 and the battery 85 as shown in Figure 1. Since some
of the elements of the alert controller 100' are substantially identical with the
alert controller 100 as described above, the following description of the alert controller
100' and its operation is largely focused on such components and operational steps
which are not present in previously described example and/or operate in a substantially
different way. This is especially the case for the alert trigger unit 130'.
[0079] The alert controller 100' comprises a history evaluation unit 145 which is adapted
to statistically evaluate data that are stored in a history stored by the memory of
the device controller 80. Among others, the history especially stores information
with respect to past drug administration and with respect to past energy consumption
and/or data from which this information can be derived.
[0080] The prediction unit 140 is adapted to predict the course of the exploitation alerting
signals, namely of the reservoir alerting signal and the battery alerting signal.
The prediction is carried out based on the data provided by the disposable monitoring
unit 110 and on prediction data supplied by the history evaluation unit145.
[0081] Prediction is performed by the prediction unit 140 for a prediction time period T
predict of, e.g., 24h. The prediction time period P
predict is divided into P
predict equal prediction intervals of length ΔT, with ΔT being, e.g, 15min. For each of the
N
predict prediction intervals, the history evaluation unit computes the average past drug
consumption V
avr_x in the corresponding x-th interval of the last N
history days, with N
history being the number of past days used for the statistical evaluation. Based on the average
past drug consumption data V
avr_x, and the drug volume V currently stored by the reservoir 20, the prediction unit
140 computes the predicted volume V
pred_x for the x-th prediction interval as

[0082] In this exemplary embodiment, the predicted course of the drug volume is a step function
which the predicted volume being constant within each prediction interval. In slightly
modified, a linear or non-linear extrapolation may be performed.
[0083] The energy which is stored by the battery 85 may be predicted by the prediction unit
in substantially the same way as the drug volume. For this purpose, the history stores
the energy which is currently stored by the battery 85 and/or the consumed energy
as determined by the battery monitoring unit 114 for at least the N
history past days. In slightly modified embodiments, the consumed energy is, totally or in
part, determined based on a mathematical energy consumption model. Alternatively or
additionally to the energy a, an indirect measure, such as the battery voltage, may
be predicted.
[0084] The predicted courses of the drug volume and the energy define the predicted course
of the corresponding alerting signals.
[0085] The exemplary alert controller 100' further comprises a user acceptance profile storage
150 which is operatively coupled to the alert trigger unit 130'. For this purpose,
the day is divided into a set of N
ACC user acceptance intervals, with the user acceptance interval length ΔT
ACC being given by 24h/N
ACC. The user acceptance profile storage 150 stores a set of N
ACC binary values ACC
x, with 'x' being a placeholder for a time interval and each value ACC
x indicating the user acceptance in corresponding user acceptance interval, wherein
a '0' indicates low user acceptance and a '1' indicates high user acceptance. The
user acceptance interval ΔT
ACC is, e.g., 15 min. In slightly modified embodiments, the user acceptance interval
length ΔT
ACC may be longer or shorter or the user acceptance profile storage 150 only stores the
times of day where the user acceptance changes. The user acceptance profile storage
150 converts the user acceptance profile into a continuous user acceptance signal.
The user acceptance profile storage 150 stores different sets of user acceptance values,
with each set of user acceptance values reflecting different situations, such as working
day, weekend, holiday, day shift, night shift, and the like.
[0086] Intervals where the user acceptance signal is Boolean '1' define user acceptance
intervals.
[0087] In slightly extended embodiments, the user acceptance signal may be modified spontaneously
and on demand by the user and/or based on user operations as described above in the
general description of the invention.
[0088] In the following, operation of the alert trigger unit 130' and supplementary components
of the alert controller 100' is described with reference to Figure 4 to Figure 6.
[0089] In step 305 of Figure 5, the disposable monitoring unit 110 determines the remaining
drug volume and the remaining energy as described above. In step 310, the exploitation
computation unit 120' computes the reservoir alerting signal and the battery alerting
signal on the basis of the drug volume and the energy. In step 315, a falling edge
of either of the reservoir alerting system or the exploitation alerting signal is
detected. In case of a falling edge, an alert trigger is generated in step 350 as
a positive pulse of an alert trigger signal. Subsequently, an alert is generated as
described above. It should be noted that in the case of a falling edge of either of
the alerting signals an alert trigger is generated independent of the user acceptance
signal.
[0090] In step 320, a falling edge of the user acceptance signal is detected, indicating
the user acceptance changing from 'high' to 'low'. If no falling edge is detected
in step 320, the computation ends with step 360. In case a falling edge of the user
acceptance signal, the course of the exploitation alerting signals, as well as the
further course of the user acceptance signal is predicted by the prediction unit 140
in step 325.
[0091] In step 330, the predicted time of occurrence of a falling edge of either of the
exploitation alerting signals is set into relation to the user acceptance signal.
If the predicted user acceptance is 'high" at the predicted time, no alert trigger
is generated, and the computation ends with step 360. This is indicative for a future
overlap interval of a user acceptance interval and a exploitation alerting interval.
[0092] If the predicted user acceptance is 'low' at the predicted time, step 335 considers,
based on the prediction of the user acceptance signal, whether the current falling
edge of the user acceptance signal is the last falling edge before the predicted time.
If this is the case, an overlap interval of a user acceptance interval and a exploitation
alerting interval is currently ending and there will be no further overlap interval
before the corresponding disposable has to be replaced at the latest. Accordingly,
an alert trigger is generated in step 350. If it is not the case, there will be a
future overlap interval of an alerting acceptance interval and a exploitation alerting
interval before the corresponding disposable has to be replaced at the latest. Consequently,
no alert trigger is generated and computation ends with step 360.
[0093] In the diagram of Figure 5 it is assumed that all operational steps are performed
with the same computation interval. In slightly modified embodiments, however, different
operational steps or sets of steps are performed with different computation intervals.
In particular, the steps 305, 310, 315 may be performed with a shorter computation
interval as compared to the other steps. The steps 305, 310, 315 may be computed with
a computation interval, of, e.g., 1 sec. or even shorter, while the remaining steps
may be performed with a longer computation interval of, e.3., 3 min. The prediction
step 325 requires the highest computational effort and may therefore be performed
with an even larger computation interval of, e.g., 15 min. The alert controller 100'
is further adapted to perform the steps as defined above on the occurrence of triggering
events such as a user interaction with the administration device and/or the occurrence
of an error state of the administration device.
[0094] According to this exemplary embodiment, an alert is generated based on the same considerations
as for the previously described exemplary embodiment. However, it additionally considers
that an alert should not be generated at a point in time where user acceptance is
low.
[0095] Figure 6a shows an exemplary course of the battery alerting signal 405, the course
of the reservoir alerting signal 410, the course of the alert trigger signal 420,
and the course of the user acceptance signal 430. The course of the signals is shown
for the current point in time t
current, such that all signal courses before the current point in time t
current are past and actual signal courses, as indicated by solid lines, while all signal
courses after the current point in time t
current are future and therefore predicted courses, as indicated by dashed lines. The predicted
course of the user acceptance signal 430 is identical with the course defined by the
user acceptance profile as long as it is not spontaneously modified. According to
this exemplary signal courses, the reservoir alerting signal is predicted to change
from '0' to '1' at a predicted point in time t
4, and back to '0' at a predicted point in time t
5, as indicated by the falling edge of the reservoir alerting signal 410. The user
acceptance is predicted to change from 'high' 'low' at a future point in time t
6, as indicated by the falling edge 434, and back to 'high' at a future point in time
t
7, as indicated by the rising edge 434 of the user acceptance signal 430. The interval
of low user acceptance may, e.g., correspond to night time. At the predicted point
in time t
5, the predicted user acceptance is high. Accordingly, the future point in time t
5 is a predicted alerting point in time, as indicated by the positive pulse 422 of
the alert trigger signal 420. The rising edge 434 of the user acceptance signal 430
and the falling edge 414 of the reservoir alerting signal 410, in combination, define
a predicted overlap interval 418 at the end of which an alert is generated.
[0096] Figure 6b shows exemplary signal courses as shown in Figure 6a at a later current
point in time, t'
current. The same reference signs are used in Figure 6b as in Figure 6a for elements which
are not changed. Points in time and signal courses which are different as compared
to Figure 6a are indicated by an additional apostrophe. In contrast to the previous
prediction, a larger amount of insulin has been administered, e.g., due to an extensive
dinner. Accordingly, the reservoir alerting signal changes from '0' to '1' and from
'1' back to '0' at earlier points in time t'
4 and t'
5, respectively, as indicated by the edges 412', 414' of the reservoir alerting signal
410. Consequently, the reservoir alerting interval 417' is shorter than the reservoir
alerting interval 417 which is shown in Figure 6a. The reservoir alerting signal is
predicted to change from '1' to '0' at a point in time where the user acceptance is
predicted to be 'low', as indicated by the user acceptance signal 430. No later falling
edge is predicted to occur for the user acceptance signal before the predicted point
in time t'
5. Accordingly, an alert trigger is generated at the current point in time. In this
case, the rising edge 412' of the reservoir alerting signal 410' and the falling edge
432 of the user acceptance signal 430, in combination, define an overlap interval
418' at which end the exploitation alert is generated.
[0097] It can be seen that alert generation is avoided at a point in time where the user
acceptance is predicted to be 'low', and is presumed to the current point in time
t_current'.
[0098] For all exemplary embodiments as described above, the alert controller 100, 100'
is comprised by the corresponding ambulatory medical device.
1. Ambulatory medical device, comprising:
a) a device controller (80), the device controller (80) being configured to control
the operation of the ambulatory medical device,
b) an alert controller (100), the alert controller (100) including a disposable monitoring
unit (110) and being configured
• to determine, based on monitoring a grade of exploitation of a first disposable
by the disposable monitoring unit (110), a first alerting interval, the first alerting
interval reflecting an earliest and a latest grade of exploitation for replacing the
first disposable, thus defining an earliest point in time and a latest point in time
for an alert generation due to approaching exploitation of the first disposable as
a first alerting cause,
• to determine, based on monitoring a grade of exploitation of a further disposable
by the disposable monitoring unit (110), a further alerting interval, the further
alerting interval reflecting an earliest and a latest grade of exploitation for replacing
the second disposable, thus defining an earliest point in time and a latest point
in time for an alert generation due to approaching exploitation of the second disposable
as a further alerting cause,
• to detect an overlap interval of the first alerting interval and the further alerting
interval,
• to determine an alerting point in time in the overlap interval,
• to generate an alert trigger at the alerting point in time,
c) an indicator (30, 33, 35), the indicator (30, 33, 35) being configured to generate
an alert upon generation of the alert trigger,
wherein the alert is a common alert for the first alerting cause and the further alerting
cause and
wherein the indicator (30, 33, 35) is configured to indicate the first alerting cause
and the further alerting cause.
2. Ambulatory medical device according to Claim 1, characterized in that the alert trigger is generated at the end of either of the alerting interval or the
further alerting interval, respectively.
3. Ambulatory medical device according to either of the previous claims, characterized by the first disposable being either of an energy storage (85), a drug reservoir (20),
an infusion line (25), an infusion cannula (27), a valve, a sealing, or a glucose
measurement probe.
4. Ambulatory medical device according to either of the previous claims, characterized by the alert controller (100) being configured to determine the alerting point in time
based on an alerting criterion, the alerting criterion comprising a time-dependent
user acceptance for the alert generation.
5. Ambulatory medical device according to Claim 4, characterized by a user acceptance storage (150), the user acceptance storage (150) being configured
to store a user acceptance profile, the user acceptance profile being indicative for
the user acceptance of alert generation as a function of time.
6. Ambulatory medical device according to Claim 5, characterized by the device controller (80) being configured to store a history and the alert controller
being configured to modify the user acceptance profile based on data stored in the
history.
7. Ambulatory medical device according to either of Claim 4 to Claim 6, characterized by a user interface (50) and/or a data interface (90, 95), wherein the alert controller
(100') is configured to temporarily modify the user acceptance of alert generation
in accordance with data provided via the user interface (50) and/or the data interface
(90, 95).
8. Ambulatory medical device according to Claim 7, characterized by the user interface (50) and/or the data interface (90, 95) being configured to receive
data defining a modification time interval, and the alert controller (100, 100') being
configured to modify the user acceptance of alert generation for that modification
time interval.
9. Ambulatory medical device according to either of Claim 4 to Claim 8, characterized by the alert controller (100, 100') being configured to modify the user acceptance of
alert generation on at least one of the occurrence a user interaction with the ambulatory
medical device, the occurrence of an error state, and the resolving of an error state.
10. Ambulatory medical device according to either of Claim 4 to Claim 9, characterized by the alert controller being configured to detect an overlap interval of high user
acceptance for the alert generation and an alerting interval, wherein the alerting
criterion is provided such that the alert trigger is generated in the overlap interval.
11. Ambulatory medical device according to Claim 10, characterized by the alerting criterion being defined such that the alert trigger is generated when
an overlap interval of an alerting interval and an interval of high user acceptance
for the alert generation ends.
12. Ambulatory medical device according to either of the previous claims, characterized by a prediction unit (140), the prediction unit (140) being configured to predict at
least one of an alerting interval or an alerting point in time.
1. Ambulante medizinische Vorrichtung, umfassend:
a) eine Vorrichtungssteuervorrichtung (80), wobei die Vorrichtungssteuervorrichtung
(80) konfiguriert ist, um den Betrieb der ambulanten medizinischen Vorrichtung zu
steuern,
b) eine Warnungssteuervorrichtung (100), wobei die Warnungssteuervorrichtung (100)
eine Einweg-Überwachungseinheit (110) aufweist und konfiguriert ist,
• basierend auf einer Überwachung eines Ausnutzungsgrads eines ersten Einwegelements
durch die Einweg-Überwachungseinheit (110), ein erstes Warnintervall zu bestimmen,
wobei das erste Warnintervall einen frühesten und einen spätesten Ausnutzungsgrad
zum Ersetzen des ersten Einwegelements widerspiegelt, wodurch ein frühester Zeitpunkt
und ein spätester Zeitpunkt zum Erzeugen einer Warnung aufgrund der Annäherung an
die Ausnutzung des ersten Einwegelements als eine erste Warnungsursache definiert
werden,
• basierend auf der Überwachung eines Ausnutzungsgrades eines weiteren Einwegelements
durch die Einweg-Überwachungseinheit (110), ein weiteres Warnintervall zu bestimmen,
wobei das weitere Warnintervall einen frühesten und einen spätesten Ausnutzungsgrad
zum Ersetzen des zweiten Einwegelements widerspiegelt, wodurch ein frühester Zeitpunkt
und ein spätester Zeitpunkt für das Erzeugen einer Warnung aufgrund der Annäherung
der der Ausnutzung des zweiten Einwegelements als eine weitere Warnungsursache definiert
werden,
• ein Überlappungsintervall des ersten Warnintervalls und des weiteren Warnintervalls
zu erfassen,
• einen Warnzeitpunkt in dem Überlappungsintervall zu bestimmen,
• um einen Warnungsauslöser an dem Warnzeitpunkt zu erzeugen,
c) einen Indikator (30, 33, 35), wobei der Indikator (30, 33, 35) konfiguriert ist,
eine Warnung beim Erzeugen des Warnungsauslösers zu erzeugen,
wobei die Warnung eine gemeinsame Warnung für die erste Warnungsursache und die weitere
Warnungsursache ist, und
wobei der Indikator (30, 33, 35) konfiguriert ist, die erste Warnungsursache und die
weitere Warnungsursache anzugeben.
2. Ambulante medizinische Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass der Warnungsauslöser jeweils an dem Ende des Warnintervalls oder des weiteren Warnintervalls
erzeugt wird.
3. Ambulante medizinische Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das erste Einwegelement entweder ein Energiespeicher (85) oder ein Arzneimittelbehälter
(20) oder eine Infusionsleitung (25) oder eine Infusionskanüle (27) oder ein Ventil
oder eine Dichtung oder ein Glukosemesssensor ist.
4. Ambulante medizinische Vorrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Warnungssteuervorrichtung (100) konfiguriert ist, den Warnzeitpunkt basierend
auf einem Warnkriterium zu bestimmen, wobei das Warnkriterium eine zeitabhängige Benutzerakzeptanz
für die Erzeugung einer Warnung umfasst.
5. Ambulante medizinische Vorrichtung nach Anspruch 4, gekennzeichnet durch einen Benutzerakzeptanzspeicher (150), wobei der Benutzerakzeptanzspeicher (150)
konfiguriert ist, ein Benutzerakzeptanzprofil zu speichern, wobei das Benutzerakzeptanzprofil
auf die Benutzerakzeptanz des Erzeugens einer Warnung in Abhängigkeit von der Zeit
widerspiegelt.
6. Ambulante medizinische Vorrichtung nach Anspruch 5, dadurch gekennzeichnet, dass die Vorrichtungssteuervorrichtung (80) konfiguriert ist, eine Historie zu speichern,
und die Warnungssteuervorrichtung konfiguriert ist, das Benutzerakzeptanzprofil basierend
auf Daten, die in der Historie gespeichert sind, zu ändern.
7. Ambulante medizinische Vorrichtung nach einem der Ansprüche 4 bis 6, gekennzeichnet durch eine Benutzeroberfläche (50) und/oder Datenschnittstelle (90, 95), wobei die Warnungssteuervorrichtung
(100') konfiguriert ist, die Benutzerakzeptanz des Erzeugens einer Warnung in Übereinstimmung
mit Daten, die über die Benutzeroberfläche (50) und/oder die Datenschnittstelle (90,
95) geliefert werden, vorübergehend zu ändern.
8. Ambulante medizinische Vorrichtung nach Anspruch 7, dadurch gekennzeichnet, dass die Benutzeroberfläche (50) und/oder die Datenschnittstelle (90, 95) konfiguriert
ist, um Daten zu empfangen, die ein Änderungszeitintervall definieren, und die Warnungssteuervorrichtung
(100, 100') konfiguriert ist, die Benutzerakzeptanz des Erzeugens einer Warnung für
dieses Änderungszeitintervall zu ändern.
9. Ambulante medizinische Vorrichtung nach einem der Ansprüche 4 bis 8, dadurch gekennzeichnet, dass die Warnungssteuervorrichtung (100, 100') konfiguriert ist, die Benutzerakzeptanz
des Erzeugens eines Alarms gemäß dem Auftreten einer Benutzerwechselwirkung mit der
ambulanten medizinischen Vorrichtung und/oder dem Auftreten eines Fehlerzustands und/oder
dem Auflösen eines Fehlerzustands zu ändern.
10. Ambulante medizinische Vorrichtung nach einem der Ansprüche 4 bis 9, dadurch gekennzeichnet, dass die Warnungssteuervorrichtung konfiguriert ist, ein Überlappungsintervall hoher Benutzerakzeptanz
für das Erzeugen einer Warnung und eines Warnintervalls zu erfassen, wobei das Warnkriterium
derart geliefert wird, dass der Warnungsauslöser in dem Überlappungszeitintervall
erzeugt wird.
11. Ambulante medizinische Vorrichtung nach Anspruch 10, dadurch gekennzeichnet, dass das Warnkriterium derart definiert ist, dass der Warnungsauslöser erzeugt wird, wenn
ein Überlappungsintervall eines Warnintervalls und eines Intervalls hoher Benutzerakzeptanz
für das Erzeugen einer Warnung endet.
12. Ambulante medizinische Vorrichtung nach einem der vorhergehenden Ansprüche, gekennzeichnet durch eine Vorhersageeinheit (140), wobei die Vorhersageeinheit (140) konfiguriert ist,
ein Warnintervall und/oder einen Warnzeitpunkt vorherzusagen.
1. Dispositif médical ambulatoire, comprenant :
a) un dispositif de commande de dispositif (80), le dispositif de commande de dispositif
(80) étant configuré pour commander le fonctionnement du dispositif médical ambulatoire,
b) un dispositif de commande d'alerte (100), le dispositif de commande d'alerte (100)
incluant une unité de contrôle d'élément jetable (110) et étant configuré
• pour déterminer, sur la base du contrôle d'un grade d'exploitation d'un premier
élément jetable par l'unité de contrôle d'élément jetable (110), un premier intervalle
d'alerte, le premier intervalle d'alerte reflétant un grade d'exploitation le plus
précoce et un grade d'exploitation le plus tardif pour remplacer le premier élément
jetable, définissant ainsi un moment le plus précoce et un moment le plus tardif pour
une génération d'alerte en raison de l'approche d'exploitation du premier élément
jetable comme première cause d'alerte,
• pour déterminer, sur la base du contrôle d'un grade d'exploitation d'un autre élément
jetable par l'unité de contrôle d'élément jetable (110), un autre intervalle d'alerte,
l'autre intervalle d'alerte reflétant un grade d'exploitation le plus précoce et un
grade d'exploitation le plus tardif pour remplacer le second élément jetable, définissant
ainsi un moment le plus précoce et un moment le plus tardif pour une génération d'alerte
en raison de l'approche d'exploitation du second élément jetable comme autre cause
d'alerte,
• pour détecter un intervalle de chevauchement du premier intervalle d'alerte et de
l'autre intervalle d'alerte,
• pour déterminer un moment d'alerte dans l'intervalle de chevauchement,
• pour générer un déclencheur d'alerte au moment d'alerte,
c) un indicateur (30, 33, 35), l'indicateur (30, 33, 35) étant configuré pour générer
une alerte lors de la génération du déclencheur d'alerte,
dans lequel l'alerte est une alerte commune pour la première cause d'alerte et l'autre
cause d'alerte et
dans lequel l'indicateur (30, 33, 35) est configuré pour indiquer la première cause
d'alerte et l'autre cause d'alerte.
2. Dispositif médical ambulatoire selon la revendication 1, caractérisé en ce que le déclencheur d'alerte est généré à la fin de l'intervalle d'alerte ou de l'autre
intervalle d'alerte, respectivement.
3. Dispositif médical ambulatoire selon l'une ou l'autre des revendications précédentes,
caractérisé en ce que le premier élément jetable est un stockage d'énergie (85), un réservoir de médicament
(20), une conduite d'infusion (25), une canule d'infusion (27), un clapet, un élément
d'étanchéité ou une sonde de mesure de glucose.
4. Dispositif médical ambulatoire selon l'une ou l'autre des revendications précédentes,
caractérisé en ce que le dispositif de commande d'alerte (100) est configuré pour déterminer le moment
d'alerte sur la base d'un critère d'alerte, le critère d'alerte comprenant une acceptation
utilisation en fonction du temps pour la génération d'alerte.
5. Dispositif médical ambulatoire selon la revendication 4, caractérisé par un stockage d'acceptation utilisateur (150), le stockage d'acceptation utilisateur
(150) étant configuré pour stocker un profil d'acceptation utilisateur, le profil
d'acceptation utilisateur étant indicatif de l'acceptation utilisateur d'une génération
d'alerte en fonction du temps.
6. Dispositif médical ambulatoire selon la revendication 5, caractérisé en ce que le dispositif de commande de dispositif (80) est configuré pour stocker un historique
et le dispositif de commande d'alerte est configuré pour modifier le profil d'acceptation
utilisateur sur la base de données stockées dans l'historique.
7. Dispositif médical ambulatoire selon l'une ou l'autre des revendications 4 à 6, caractérisé par une interface utilisateur (50) et/ou une interface de données (90, 95), dans lequel
le dispositif de commande d'alerte (100') est configuré pour modifier temporairement
l'acceptation utilisateur d'une génération d'alerte conformément à des données fournies
par le biais de l'interface utilisateur (50) et/ou de l'interface de données (90,
95).
8. Dispositif médical ambulatoire selon la revendication 7, caractérisé en ce que l'interface utilisateur (50) et/ou l'interface de données (90, 95) sont configurées
pour recevoir des données définissant un intervalle de temps de modification, et le
dispositif de commande d'alerte (100, 100') est configuré pour modifier l'acceptation
utilisateur d'une génération d'alerte pour cet intervalle de temps de modification.
9. Dispositif médical ambulatoire selon l'une ou l'autre des revendications 4 à 8, caractérisé en ce que le dispositif de commande d'alerte (100, 100') est configuré pour modifier l'acceptation
utilisateur d'une génération d'alerte sur au moins l'une parmi l'occurrence d'une
interaction utilisateur avec le dispositif médical ambulatoire, l'occurrence d'un
état d'erreur et la résolution d'un état d'erreur.
10. Dispositif médical ambulatoire selon l'une ou l'autre des revendications 4 à 9, caractérisé en ce que le dispositif de commande d'alerte est configuré pour détecter un intervalle de chevauchement
d'acceptation utilisateur élevée pour la génération d'alerte et un intervalle d'alerte,
dans lequel le critère d'alerte est fourni de telle sorte que le déclencheur d'alerte
est généré dans l'intervalle de chevauchement.
11. Dispositif médical ambulatoire selon la revendication 10, caractérisé en ce que le critère d'alerte est défini de telle sorte que le déclencheur d'alerte est généré
quand un intervalle de chevauchement d'un intervalle d'alerte et un intervalle d'acceptation
utilisateur élevée pour la génération d'alerte prend fin.
12. Dispositif médical ambulatoire selon l'une ou l'autre des revendications précédentes,
caractérisé par une unité de prédiction (140), l'unité de prédiction (140) étant configurée pour
prédire au moins l'un parmi un intervalle d'alerte et un moment d'alerte.